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Credit Application

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Generic credit application

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									Individual Credit Application
Date: ___________________________________________ Name: _____________________________________________________________ Street Address: _____________________________________________________ City/State/Zipcode _________________________________________________ Business Phone: ______________________ Home Phone: ________________ Social Security Number: ____________________________________________ Employer: __________________________________________________________ Employer Address: __________________________________________________ Spouse Name: ______________________________________________________ Spouse Social Security Number: ______________________________________ Persons to use this account: ________________________________________ ____________________________________________________________________ ____________________________________________________________________
In consideration of extension of credit, the undersigned hereby agrees to the terms and conditions of all sales as follows: 1. Terms of sale are: Net due 10th of each month following purchases. Invoices not paid within such time will be past due and are subject to a service charge of ______ percent per month. 2. Should this account upon default, be collected by an attorney at law, the undersigned agrees to pay all reasonable attorney’s fees in addition to the principal indebtedness and interest thereon.

I HAVE READ AND UNDERSTAND THE ABOVE TERMS : __________________________________________________________ Applicant Signature _________________________________________________________ Date

For office use only: ___________________________________________________________________________ Approved _____________Denied __________________ Reason __________________ Credit Limit _________________ Manager Signature __________________________

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